Case Study: Psoriasis

This month’s case study is 40 year old Stephanie who came to the Clinic with Psoriasis


I had suddenly started developing red scaly patches over my elbows, trunk and scalp. It looked unsightly and I found it embarrassing wearing anything that exposed the affected areas. I went to my GP who diagnosed psoriasis. I actually thought it was eczema so was surprised when my GP said it was psoriasis, which I didn’t know much about. He explained that it was a non-contagious auto-immune condition, which meant my immune system was ‘attacking’ my skin cells causing the rate of cell renewal to speed up. So it manifests as a hard scaly condition where the cells are ‘stacked’ up on one another. He said it can sometimes even develop in the joints causing inflammation and pain. He prescribed me some topical creams and also an anti-inflammatory drug (called Methotrexate) to suppress my immune system and control the symptoms. I was someone who never took a painkiller for a headache, so this was quite a shock for me and I was not happy about using drugs as a treatment. However, I was desperate to get this under control so I took the prescribed course of treatment.

I spent time researching psoriasis on the internet and came across lots of useful information and I spoke to some of my colleagues at work. A friend had asked me whether I had looked into my diet because she herself had found it beneficial for her eczema. She had in fact been to see a nutritionist at a clinic in London which she recommended to me. I phoned the Dr Marilyn Glenville Clinic straight away and I chatted to a very helpful nutritionist who reassured me that psoriasis was a condition they had experience in treating. She transferred me to a receptionist who booked my first appointment. This was arranged for two weeks so I didn’t have long too wait. In the meantime I was asked to complete a detailed health questionnaire that would help the nutritionist assess me and put together a tailored diet and supplement programme. I also had to write a food diary, which really made me think about what I was eating. I thought my diet was OK on the whole, but was conscious I was drinking too much coffee and possibly not enough fresh fruit and vegetables.


The nutritionist recommended that I perform a mineral deficiency test (via a hair sample) before my first meeting. This would give her more information about my nutritional status as certain minerals, like zinc, play an important role in skin health and the immune system.


At my appointment the nutritionist really went into a lot of detail about what psoriasis was, how it starts and the treatments available. She explained that it is ‘multi factorial’ (which means there are several factors that influence the condition, including our immune system, food allergies/sensitivities and poor liver function). She went on to explain that ‘healthy’ skin cells take approximately 28 days to develop, but with psoriasis this process only takes 8 days – so the cells build up on top of one another creating a very hard, scaly effect. The reason that drugs like Methotrexate work is because it interferes with the growth of skin cells by altering the body’s use of folic acid, which is an essential vitamin for the development of our cells.  


The nutritional approach is to support the immune system and liver and calm inflammation in the body by modifying the diet and taking specific supplements. She did pick up on my diet containing a lot of caffeine and lacking fruit and vegetables. She explained how caffeine can interfere with the healthy function of the liver and increase the rate at which I excrete minerals out of my body in my urine. She recommended I eat more dark green vegetables which contain vitamins and minerals to support liver function and detoxification. She also recommended I eat a lot more fruit and vegetables that are red, orange and purple because these contain a compound called beta carotene, which is converted into Vitamin A (with sufficient zinc). Vitamin A is one of the nutrients that regulates and normalises skin cell turnover.  


The nutritionist also recommended that I get my Vitamin D levels measured because of the increasing amount of research linking low levels of Vitamin D and auto-immune disorders. She explained that there was a rising incidence of vitamin D deficiency, partly because of less sun exposure, but also because we are using skin products with SPF which naturally blocks our ability to process Vitamin D from sunlight.


The nutritionist went through my hair mineral analysis results which showed that I was low in zinc. She said this was not surprising as zinc is crucial for the normal functioning of the immune system and cell division. She recommended lots of zinc-rich foods I could incorporate into my diet and said that zinc is one of the minerals that can be excreted out of our body as a result of too much caffeine.


She put together a supplement programme I could take in conjunction with the Methotrexate, with the hope that after 3-6 months I would be on a reduced dose. She gave me a general multi vitamin and mineral together with high strength fish oil to calm the inflammation, an antioxidant containing Vitamin A, milk thistle for my liver and additional zinc. She recommended that I leave them out on the day of taking the Methotrexate.


At the next consultation, which was 6 weeks on, I brought back my completed diet diaries – which I must say had been very motivating and really helped me to keep on track. My skin was improving, which was such an incentive to continue – I still had the same patches on my body but the redness and hard scales had definitely reduced. I had stopped using the topical cream and had already cut my dose of Methotrexate, which was amazing.  


The results of my Vitamin D test were back and it showed I had incredibly low levels – almost off the bottom of the scale – so the nutritionist added an extra supplement. It was in liquid form, taken under the tongue every morning.


Another 6 weeks on and I barely recognised myself! The patches of psoriasis had almost disappeared – in fact it had gone altogether from my scalp. I had so much more confidence in my appearance and I no longer felt like I had to cover myself up. I also had more energy, which I had never really thought about as being a problem, but following this new improved way of eating made me realise that I hadn’t been functioning on all four cylinders for a long time.


I was really enjoying my new diet and not missing the coffee at all – although I was allowed 3 cups a week as a treat. I was actually craving broccoli if I went more than a day without it, which I never thought would be possible! Thank you to the nutritionist and all the team at The Dr Marilyn Glenville Clinic for helping me to get my health back without having to take drugs the rest of my life.


Marilyn’s Comment


This is such an inspiring case and another example of how powerful nutrition is. As we saw Stephanie was naturally very distressed suffering with psoriasis and, although she initially wanted to deal with the symptoms as quickly as possible, she knew the drugs would only be suppressing her condition and not dealing with the cause.   


Stephanie has been able to manage her skin condition through eating a better diet and taking supplements and the improvement was significant in a short space of time. Six months on and she still remains largely symptom free and when she does have a flare up she knows why. She has managed to come off the Methotrexate, but she did this with the guidance of her GP who was supportive and encouraging of her that she had managed to help herself naturally.


If you would like to find out more about our clinics and the tests mentioned, then please see the Resources Page.

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